Individual
DR. LUCIANO JO SARABOSING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J7177
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038MN
BLUECROSSS BLUESHIELD
TX
05
—
135718809
—
TX
01
—
16758440
DRIVER'S LICENSE
TX
05
—
170867901
—
TX
05
—
170867902
—
TX
01
—
45D1037942
CLIA
TX
01
—
J7177
STATE MEDICAL LICENSE
TX
01
—
N0089582
TEXAS CONTROLLED SUBSTANC
TX
Enumeration date
05/28/2006
Last updated
03/07/2023
Update your record
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